If you’ve recently had a heart attack or had a stent placed in one of your coronary arteries, you may have been prescribed a medication called ticagrelor, commonly known by the brand name Brilinta. As cardiologists, we often use this medicine to help prevent further heart problems — but it’s completely understandable to want to know why you’re taking it, how it works, and what to expect.
This article will help guide you through those questions in a way that’s clear and practical.
What Is Ticagrelor?
Ticagrelor is an antiplatelet medication. Its main role is to prevent blood clots from forming inside your blood vessels, particularly in the arteries of the heart. Blood clots can be dangerous because they can block blood flow, leading to serious events like heart attacks or strokes.
Your platelets are small cells in your blood that normally help stop bleeding by clumping together and forming clots. While this is a useful function when you have a cut or injury, it becomes a problem when platelets clump inside a narrowed or stented artery. That’s where ticagrelor comes in — it reduces platelet activity to lower the risk of these harmful clots.
Why Might Your Doctor Prescribe It?
Ticagrelor is most commonly prescribed to people who have had a recent heart attack, unstable angina, or percutaneous coronary intervention (PCI) — such as the placement of a coronary stent. These situations all increase the risk of blood clots forming within the heart’s arteries or around the stent itself. This medicine is usually commenced during your hospitalization by your treating team.
The medication is typically prescribed alongside low-dose aspirin, a combination known as dual antiplatelet therapy (DAPT). This pairing provides stronger protection against clot formation than either medication alone.
Your cardiologist will advise you on how long to continue ticagrelor, depending on your individual situation. In many cases, treatment may be considered for 6 to 12 months, but the exact duration can vary based on the type of stent, the nature of your heart condition, your bleeding risk, and other clinical factors. It’s important to follow your doctor’s advice and attend regular follow-up appointments to reassess your ongoing treatment.
After a stent is placed during a heart attack, there is a small risk that the body may respond by forming small clots, made up of platelets and other blood components, around the stent. Ticagrelor helps reduce this risk while the stent heals and gradually becomes incorporated into the wall of the artery.
How Does It Work?
Ticagrelor works by blocking a receptor on the surface of platelets known as P2Y₁₂. This prevents the platelets from becoming activated and sticking together. Unlike older medications like clopidogrel, which need to be converted into their active form by the liver, ticagrelor works directly and more quickly, which means it can provide a more consistent antiplatelet effect.
Because of this, ticagrelor is often the preferred option in people who need reliable protection against clotting — especially in the days and weeks immediately following a heart attack or stenting.
How Should You Take It?
Ticagrelor is usually taken as 90 mg twice a day, 12 hours apart, alongside a daily aspirin tablet. It’s important to take it at the same time each morning and evening to keep its effect steady.
If you accidentally miss a dose, take it as soon as you remember, unless it’s almost time for the next one — in that case, skip the missed dose and continue with your normal schedule. Don’t double up to make up for a missed dose.
Try to avoid stopping this medication without discussing it with your doctor. Doing so could increase your risk of developing a serious clot.
What Side Effects Should You Watch For?
Like any medication, ticagrelor can cause side effects. Most people tolerate it well, but some may notice certain symptoms — some of which can be unsettling if you’re not expecting them.
The most common side effect we see is shortness of breath, or a sensation of breathing a little heavier than usual. This can happen especially in the first few weeks after starting the medication. It’s usually mild and not related to a lung or heart problem — it’s thought to be due to how the drug interacts with receptors in the body. For most people, this side effect eases over time, but if it persists or worsens, speak to your doctor.
Another important consideration is bleeding. Since ticagrelor reduces your blood’s ability to clot, you may notice:
- Easy bruising
- Nosebleeds
- Bleeding gums
- Longer bleeding from cuts
- More serious bleeding — such as vomiting blood, black tarry stools, or signs of internal bleeding — is rare but requires urgent medical attention.
Other possible side effects include headaches, dizziness, and occasionally a slower heart rate, particularly in people with underlying rhythm issues.
Is Ticagrelor Suitable for Everyone?
While ticagrelor is very effective, it’s not right for everyone. Your doctor will have considered a number of factors before starting you on this medication.
It may not be suitable if you:
- Have a history of major bleeding, such as a bleeding stomach ulcer
- Have had a stroke caused by bleeding (haemorrhagic stroke)
- Are taking other medications that thin the blood (e.g. warfarin or DOACs)
- Have severe liver diseas
- Your doctor may also monitor you more closely if you have asthma, COPD, or are taking medications that interact with ticagrelor — such as strong antibiotics, antifungals, or seizure medicines.
Conclusion
Ticagrelor is a key part of modern heart care, particularly after procedures like stenting or events like a heart attack. It’s a medication that significantly reduces your risk of future events by protecting the arteries from dangerous clot formation.
Like any powerful medicine, it comes with considerations and potential side effects but with proper guidance and regular follow-up, it can be taken safely and effectively. If you’re on ticagrelor and ever feel unsure, have concerns about bleeding, or experience new symptoms, speak to your doctor or pharmacist. You’re not alone in this and understanding your treatment is an important step in feeling more confident about your heart health.
Peter is an interventional cardiologist and the Founding Editor of Heart Matters, a trusted resource for heart health education. With more than 20 years of clinical experience, he is dedicated to making cardiovascular care more understandable and accessible. His work bridges patient care, research, and public education, empowering individuals to take control of their heart health. Professor Barlis is internationally recognised for his contributions to cardiology, with numerous publications and speaking engagements around the world.
